The brain and spinal cord communicates with what is occurring in the internal organs and limbs by nerve fibers where are like electrical wires with insulation (myelin) and the "copper" (axon). Within brain and spinal cord these nerves connect to other nerves via synapses on both axons and dendrites. A nerve can carry information regarding sensations, and also commands for function.
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5

Not advised:
Because both drugs are nervous system depressants, there is a potential for at least an additive effect. Spacing out the medications and avoiding activities like driving or operating machinery would be a start.
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6

Not safe:
No. In my opinion, that is unsafe, with mutip;le risks, some potentially very serious. A starting dose would be 10 to 50 mg total daily. To go higher should involve increments, but for nerve pain, it is unusual to need more than 50 to 100 mg total per day. 300 mg per day is rarely needed for depression.
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8

Don't!:
Gabapentin is an anti-seizure medication and is used for nerve pain. At 3200mg/day, you are at higher dose for gabapentin. You need to be weaned off Gabapentin if desired. If you stop abruptly, you might develop seizure. Please see your doctor before making any change.
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That is reasonable:
Often times when treating people with nerve pain the dose of gabapentin needs to be titrated up until the effective dose is reached (since the effective dose is different for each individual). The maximum recommended dose is 3600mg per day, so 1500mg is well within a safe range.
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11

2 intertwined issues:
First need proper diagnosis & definitive treatment for the "facial nerve pain". Certain injections can be effective and neurosurgical procedures may provide definitive cure. At the same time, need to taper with goal of getting off methadone. Can add anticonvusants or tricyclics. Getting off hi dose Methadone and getting your pain properly treated can only improve your mental condition.
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Elavil (amitriptyline):
Please call your doctor about your difficulties with elavil, since you haven't shared how much you're taking. The lowest dose made is 10mg, and I don't know any that are scored (making them easier to cut in half) anyway. You may end up with a crumbled pill. Your doctor will want to understand what you mean by "too strong, " so s/he can adjust or change. Another option might be low-dose sinequan (doxepin).
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16

Go to PCP first:
Nortriptyline is an antidepressant under the class called tricyclics that can help depression and anxiety. The dose depends on you age, the degree of depression and anxiety, weight and whether you have medical conditions that preclude the use of this drug or if you have other drugs you are taking. See your pcp for an appropriate referral.
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17

See a specialist:
Antidepressant dose is typically 75mg+ (up to ~150mg). Many patients experience intolerable side effects, which is why this type of med is not often used for depr anymore. You should also know that only a small % of patients respond to antidepressant meds (beyond a placebo effect). Psychotherapy should be part of the plan. You have a serious problem-- definitely see a mental health professional.
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19

Usually low doses of:
Nortriptyline are used for migraine or other headaches.10mg at bedtime is often used as a starting dose and it may be worked up until a dose of 150mg/ day. Very low doses of nortriptyline will usually not be therapeutic for depression but higher doses can be.
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21

OD concerns:
There is no exact answer as metabolism depends on multiple factors. Nortriptyline is a tricyclic antidepressant and has many different side effects. It is safe at prescribed doses but it is a VERY dangerous drug to take as an overdose. If you have ANY concerns that some is stockpiling or has suicidal idealizations please urge them to seek professional help or call the paramedics or police.
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22

Yes:
It is important to maintain your schedule for your medications, but if you do miss a dose try and take it as soon as you remember unless your next dose is due soon. If you have any questions/concerns it's always a good idea to talk to your doctor.
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25

Nortriptyline:
Hi, yes it is very small dose but you might still develop some side effects like dry mouth, constipation, nausea, drowsiness in first couple of weeks but those will go away.
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27

Side effects persist:
Established blood level measuring and therapeutic ranges are available to guide dosing and provide feedback if doses threaten safety for example cardiac. Most abandon meds that provide significant side effects. They can be unpleasant but can cause various medical problems in their own right. Weight gain, dry eyes/mouth, urinary hesitancy, sedation, memory problems. All are reversible.
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28

Call med prescriber.:
If you are not feeling better on nortriptyline from the perspective of mood, sleep, appetite, and energy, then your depression may not be responding to this particular medication. I recommend that you talk with the prescriber of the nortriptyline about other potentially beneficial approaches that you have not yet tried and that may be different in how they treat depression.
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29

Usual warning:
Unfortunately tricycle antidepressants have been an uncommon triggers of suicidal ideation. Sometimes headaches and other somatic complaints can be related to depression, and a diagnosis is necessary. It would be a good idea to consult with your doctor so that he can apply some screening questionnaires to rule out an underlying depressive disorder.
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Not necessarily:
Adjusting medication doses is individual, and your doctor will appreciate knowing what you're experiencing. The 50mg dose may be just right for you, but might not have been recognized until the additional 25 mg was added (and you got more anxious). Please work with your physician on this.
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Classified as a tricyclic antidepressant, and considered of modest benefit these days due to significant anti-cholinergic side effects (drowsiness, dizziness, dryness of mouth, blurring, and perhaps effect on bladder). Confusion may occur in older folks. Had some value in migraine prevention at one point. Used rarely these days as better meds are available.
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Can also be described as neuropathic pain or "nerve pain" which can occur anywhere in the body. It can also be due to many disorders such as direct nerve damage, diabetes, trigeminal neuralgia, or infection.
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